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Gastrointest Endosc. 2015 Nov;82(5):912-23. doi: 10.1016/j.gie.2015.04.039. Epub 2015 Jun 9.

Endocytoscopic microvasculature evaluation is a reliable new diagnostic method for colorectal lesions (with video).

Author information

1
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
2
Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan; Department of Gastroenterology and Hepatology, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
3
Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.

Abstract

BACKGROUND:

We previously reported on the efficacy of endocytoscopic classification (EC-C). However, the correlation of the endocytoscopic vascular (EC-V) pattern with diagnoses was unclear.

OBJECTIVE:

To assess the diagnostic accuracy of the EC-V pattern for colorectal lesions.

DESIGN:

Retrospective.

SETTING:

A university hospital.

PATIENTS:

Patients who underwent endocytoscopy between January 2010 and March 2013.

INTERVENTION:

We evaluated 198 consecutive lesions according to the EC-V pattern (EC-V1, obscure surface microvessels; EC-V2, clearly observed surface microvessels of a uniform caliber and arrangement; and EC-V3, dilated surface microvessels of a nonhomogeneous caliber or arrangement).

MAIN OUTCOME MEASUREMENTS:

The diagnostic accuracy for predicting hyperplastic polyps and invasive cancer were compared between the EC-V pattern and other modalities (narrow-band imaging, pit pattern, and EC-C).

RESULTS:

The sensitivity, specificity, and accuracy of the EC-V1 pattern for diagnosing hyperplastic polyps were 95.5%, 99.4%, and 99.0%, respectively. The sensitivity, specificity, and accuracy of the EC-V3 pattern for diagnosing invasive cancer were 74.6%, 97.2%, and 88.6%, respectively. The diagnostic accuracy of the EC-V pattern for predicting hyperplastic polyps was comparable to the other modalities. For predicting invasive cancer, the EC-V pattern was comparable to narrow-band imaging and pit pattern, although EC-C was slightly more accurate (P = .04). In the substudy, the diagnosis time by using the EC-V pattern was shorter than that with the EC-C pattern (P < .001).

LIMITATIONS:

A single-center, retrospective study.

CONCLUSIONS:

The EC-V pattern saved more time than the EC-C pattern and had a diagnostic ability comparable to that of other optical biopsy modalities.

PMID:
26071058
DOI:
10.1016/j.gie.2015.04.039
[Indexed for MEDLINE]

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